Navigating the Paradox: Is Morgan Health’s Investment a Blueprint for Disruption or a Manifestation of the Status Quo?
Chris Deacon
Speaker. Thought Leader. Truth Teller. Disruptor. *All content non-AI Generated*
Morgan Health, an ambitious venture by J.P. Morgan, embarked on the healthcare sector with the aim to revolutionize and innovate employer-sponsored healthcare. With the commitment to reform employer-based health coverage, the venture aspires to reformulate the healthcare landscape for the myriad Americans anchored to job-based coverage. However, the most recent announcement of their investments in the established entities of Virgin Pulse and HealthComp, stir reflections on whether Morgan Health is truly the harbinger of disruption it promises to be, or if it is inadvertently becoming a pillar supporting the current paradigms.
?The New Joint Venture
The merger between Virgin Pulse and HealthComp is poised to produce a “platform aimed at aiding employees of self-insured employers in navigating and utilizing their health benefits efficiently. “[i] The alliance aspires to redefine the modalities through which employers can curtail costs while enhancing member outcomes. The fusion of these entities claims to serve over 20 million individuals and above 1,000 self-insured employers.
HealthComp is a Third-Party Administrator (TPA), and presents itself as a cost management solution, offering services to facilitate the relationship between employers and healthcare providers by managing and processing claims, and providing insightful data analytics. The organization promotes the fact that it offers access to all major provider networks including Anthem, Blue Shield CA, National BlueCard, and Cigna, among other regional PPO networks.
However, the affiliation with HealthComp inherently carries the baggage of the challenges associated with these national carrier networks.[ii] Many of these carriers, notorious for imposing restrictions on the utilization of data, access to pricing information, and auditability of provider claims, even in cases where these networks are just rented, could potentially impede the disruptive trajectory that Morgan Health envisions.
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Virgin Pulse is?a cloud-based employee wellbeing solution for businesses to promote a healthy lifestyle, improve workforce practices, and increase engagement among employees. Through this platform, Virgin Pulse claims to impact over 100 million people across 190 countries by helping Fortune 500, national health plans and other organizations by gaining true human insights and inspiring action for the benefit of individuals and organizations.[iii] While Virgin Pulse may be top notch vendor in the corporate wellness space (indeed, they were selected by J.P. Morgan for their own employees), there are reasons to doubt the financial impact of such programs when it comes to overall healthcare costs.?
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A meticulous study published in 2021 in Health Affairs underscored the inefficacy of corporate wellness programs, highlighting no significant differences in various health and performance parameters after three years, despite improved health behaviors. These findings project a stark contrast to the promises made by wellness vendors, like Virgin Pulse, who often portray corporate wellness programs as the golden key to improved employee health and reduced preventive medical expenditures.
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Irony in Disruption
So, does alignment with entities like Virgin Pulse and HealthComp underscore the paradoxical essence of Morgan Health's mission? Can organizations that are deeply ingrained within the current industry paradigms truly serve as the architects of disruption and transformation in a sector plagued by inefficiencies, stagnated models, and spiraling costs?
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?Unraveling the Contradictions
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Dan Mendelson, the CEO of Morgan Health, asserts the integration of the new assets will be swift and will revolutionize how patients and employers interact with healthcare platforms and benefits administration. ?How many times have we heard the proclamation of revolutionary platforms that promise to be “game-changers”?? A lot.? And the outcomes are usually anti-climactic and reminiscent of familiar patterns. As observers, we’ve heard the promises and seen the ensuing disappointments too many times.? Partnership with organizations that seem to represent the very essence of the prevailing system, appear to be more reflective of a consolidation of the existing norms rather than a radical transformation of the healthcare landscape.?
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?Reimagining Disruption
The journey of Morgan Health raises compelling questions about the nature of innovation and disruption in healthcare. By investing in entities deeply ingrained in the existing system, is Morgan Health potentially risking the dilution of its mission to improve the quality, equity, and affordability of employer-sponsored healthcare?
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The embrace of established, conventional vendors seems to contrast starkly with the disruptive spirit and vision that Morgan Health espouses. A genuine transformation of the employer health cost domain demands more than a superficial overlay of new technologies on existing structures; it requires a fundamental rethinking and reshaping of the prevailing models and paradigms.
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?Conclusion
Morgan Health, amidst its ambition and potential, finds itself at a crossroad. The venture’s alignment with entities like Virgin Pulse and HealthComp forces us to contemplate whether the strategies being adopted are indeed paving the way for a healthcare revolution or merely retracing the well-trodden paths of the status quo.
I am going to take a wait and see approach, holding space for the potential unfolding of true innovation and disruption, hoping that Morgan Health, with its abundant resources and declared commitment, can traverse beyond the redundancies and truly contribute to a paradigm shift in employer-sponsored healthcare.
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However, we should be committed to scrutinizing Morgan Health's endeavors not through the prism of their promises but through the tangible, impactful changes they can bring about in the healthcare landscape. The healthcare sector is watching, and the hope is mixed with a measured skepticism and a cautious optimism that this time, it might be different.
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Is the industry witnessing the inception of groundbreaking frameworks, or are we observing the subtle reinforcement of the existing, flawed paradigms? Only time will unveil whether Morgan Health will fulfill its promise as a transformative force or become a reflection of unmet aspirations, reminiscent of past ventures.
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It’s frustrating to see Morgan follow a path to disruption that includes networks. Haven did the same thing. Real progress will be made when employers are able to “direct contract” with high quality providers outside of BUCA constraints. It’s the natural progression from RBP. Direct contracting will improve health, lower claim costs, and with the right oversight (empowered fiduciaries) put a dent in FWA. Direct Contracting is the real disruption needed to bring real change.
The industry's leader in employee health education, vendor outcomes measurement, ER cost reduction, and shameless self-promotion.
1 年Here is a compelling datapoint to dispel the notion that somehow better primary care will make significant reductions in healthcare costs in the <65 employer-insured population. If you scroll down this artcile, you'll see a chart of the top 25 hospital DRGs in that population. (It's 2013 data and is no longer collected in a usable format, but there's no reason to think it's suddenly changed.) See if you can find a single one where a patient would say: "If only I had access to a better-credentialed PCP" https://www.ajmc.com/view/chronic-disease-in-the-workplace-are-we-fighting-the-wrong-battle
VP, Employee Benefits at Prudential Financial
1 年Insightful and agree - let's wait and see.
Behavioral health & wellbeing advocate, especially in the workplace. Co-Founder, President ADoH SCIENTIFIC LLC
1 年Paying half of total US healthcare expenses, employers will be the drives of transformation. These JVs may work if they enable employers to get out of the "best practices' and truly help their employees be healthy.
CCI
1 年“Let’s see if this venture can fulfill its transformative promises.” Why would you assume this is JPM’s motivation? The structure always reveals everything the press release doesn’t.